1437107141 NPI number — DR. SUSAN ELIZABETH RINDT PSYD

Table of content: DR. SUSAN ELIZABETH RINDT PSYD (NPI 1437107141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437107141 NPI number — DR. SUSAN ELIZABETH RINDT PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RINDT
Provider First Name:
SUSAN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MULHOLLAND
Provider Other First Name:
SUSAN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSYD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437107141
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3790 VIA DE LA VALLE
Provider Second Line Business Mailing Address:
SUITE # 118E
Provider Business Mailing Address City Name:
DEL MAR
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92014-4247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-342-9135
Provider Business Mailing Address Fax Number:
760-634-1981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3790 VIA DE LA VALLE
Provider Second Line Business Practice Location Address:
SUITE # 118E
Provider Business Practice Location Address City Name:
DEL MAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92014-4247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-342-9135
Provider Business Practice Location Address Fax Number:
760-634-1981
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY 18895 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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